Ask Dr./Sleep Specialist Internet

I've had a CPAP for about a year now, and I've yet to sleep through the night with it on. Every time I try a new mask or setting I hope it's going to make the kind of life-changing difference I keep hearing about, but so far I really can't say I notice a difference between the nights when I use it and those when I don't.

My entire life I've been tired more often than not, and I'm sick of it. I've been trying to get more serious about finding a solution lately, following up with my doctor more frequently, but at this point I'm looking for whatever resources I can find (within reason).

Now, I know better than to go to social media for Real Medical Advice, but then again I also know a lot of y'all also use CPAPs, so maybe someone out there knows a specialist or other solution I might do well to look into further? Maybe some of you have even had something like the experiences I'll describe next, and found a way to deal with them?

Here's what I've tried so far...

• CPAP with full face mask: The problem with taking the thing off in my sleep is that I can only be so sure of the reason(s). I recall frequently having the sensation that the CPAP has started to make it harder to breathe, rather than easier. I specifically recall a sensation I can only describe as there not being "enough air in my air", like I'm suddenly not getting enough oxygen. I would suspect that maybe the mask isn't venting my exhalations well enough and there's CO₂ building up, but really I have no idea.
  
  Also, silly as it may sound, rare is the night when my nose doesn't itch, and when you're asleep and your nose itches and something is stopping you from scratching that itch, your thought process doesn't get much more complicated than "ungh... uncomfortable thing... make go 'way now...".
  


• CPAP with nasal mask, and CPAP with nasal pillows mask: At first I was worried that a nasal mask wouldn't work for me because at least half of my nose is almost always stuffy, and my ENT doc says I have "severe septal deviation" (which is totally the name of a metal band I'm going to form), but I've found that that part actually works ok. The problem is... weirder.
  
  Every night, just as I'm about to actually lose consciousness, something stops me from breathing in-- there have been times when I've awakened to a sensation that feels like "central" apnea, as opposed to obstructive apnea. In other words nothing is blocking my airway, my body's just gotten so relaxed that my brain has, just for a bit, forgotten to remind my lungs to breathe. I know that during my initial sleep studies they noted both central and obstructive apneas, so I am prone to this, but the kind of CPAP I'm using (the super fancy "adaptive servo ventilation" kind for those playing along at home) is supposed to prevent central apneas.
  
  So ok, maybe I'm just making this up and it's actually obstructive; point is, at some point some kind of apnea happens despite the CPAP, and this causes problems. When the CPAP tries to make me inhale pressure builds up in, but instead of forcing my airway open, my lips prove to be the weaker seal and I start... blowing rasberries every few seconds.
  
  This is very embarrassing. And annoying. And it wakes me up. Off goes the mask, and I take my chances sleeping sans mechanical assistance. Again.
  


• Tongue Suppression Device (TSD): This one's weird, kind of a cross between a pacifier and bondage gear. It uses suction to grab onto my tongue so that I sleep with it effectively sticking out, the idea being that this prevents my tongue from drifting back and blocking my airway while I sleep. Does it work? Well, I've managed to get through the night with it once or twice, and... maybe, I think? It's really hard to quantify the differences, especially with my other sleep issues going on (e.g. this morning, when I woke up after about 6 hours of sleep, having slept 4ish the night before, completely hyper-- not awake per se, I would love to go back to sleep, just completely full of nervous energy, like a sugar high with no cause I can think of).
  
  Even if the TSD is effective it's hard to stick with because... well you try and sleep with someone pulling on your tongue all night. :\

So... yeah. That's where I'm at. I try sleeping on my side instead of my back, and at least start most nights with one of the above devices. I experimented once with using the nasal cpap and TSD together, which they're not designed to do, but if the problem with the nasal cpap is obstructive apnea after all... warrants further investigation I guess, but gah, there's only so much a fella can be expected to strap to his head in a night. Anyway, I digress.

Anyone have any familiarity with the above? Know a miracle worker who listened well and worked with you to find a creative solution to your own problems? Do tell!

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